Corneal integrity after refractive surgery. Effects of radial keratotomy and mini-radial keratotomy. 1995

M N Pinheiro, and M R Bryant, and R Tayyanipour, and B A Nassaralla, and W R Wee, and P J McDonnell
Doheny Eye Institute, Los Angeles, CA 90033.

OBJECTIVE Mini-radial keratotomy (mini-RK) involves limiting the extent of radial incisions to within 3.5 mm from the center of the central clear zone, compared with incisions that extend close to or beyond the limbus, as with "conventional" RK. This study was designed to determine if shorter incision length reduces the likelihood of corneal rupture after blunt trauma. METHODS Sixteen fresh human anterior segments were divided into four groups and mounted onto an artificial anterior chamber. Four corneas with no incisions were used as controls, four received regular four-incision RK, four received four mini-RK incisions, and four received eight mini-RK incisions. Incisions extended from the 3.0-mm central clear zone to 1 mm inside the limbus (regular RK), or from the 3.0-mm central clear zone to the 7.0-mm mark (mini-RK). A pump slowly infused the artificial anterior chamber with a balanced salt solution while the pressure was continuously monitored with an electronic pressure transducer. The maximum pressure and the site of the rupture were recorded. RESULTS Control corneas ruptured at the limbus, whereas all surgical eyes ruptured at incision sites. The corneas subjected to mini-RK ruptured at significantly higher pressures than corneas that had undergone regular RK (P < 0.01). CONCLUSIONS Reducing incision length appears to reduce the likelihood of corneal rupture as intraocular pressure is increased. Mini-RK may be advantageous for patients at high risk for ocular trauma.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D007646 Keratotomy, Radial A procedure to surgically correct REFRACTIVE ERRORS by cutting radial slits into the CORNEA to change its refractive properties. Radial Keratotomy,Keratotomies, Radial,Radial Keratotomies
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012421 Rupture Forcible or traumatic tear or break of an organ or other soft part of the body. Ruptures
D013529 Surgical Wound Dehiscence Pathologic process consisting of a partial or complete disruption of the layers of a surgical wound. Dehiscence, Surgical Wound,Wound Dehiscence, Surgical
D014945 Wound Healing Restoration of integrity to traumatized tissue. Healing, Wound,Healings, Wound,Wound Healings
D014949 Wounds, Nonpenetrating Injuries caused by impact with a blunt object where there is no penetration of the skin. Blunt Injuries,Injuries, Nonpenetrating,Injuries, Blunt,Nonpenetrating Injuries,Blunt Injury,Injury, Blunt,Injury, Nonpenetrating,Nonpenetrating Injury,Nonpenetrating Wound,Nonpenetrating Wounds,Wound, Nonpenetrating
D054140 Refractive Surgical Procedures Surgical procedures employed to correct REFRACTIVE ERRORS such as MYOPIA; HYPEROPIA; or ASTIGMATISM. These may involve altering the curvature of the CORNEA; removal or replacement of the CRYSTALLINE LENS; or modification of the SCLERA to change the axial length of the eye. Keratorefractive Surgical Procedures,Refractive Surgery,Keratorefractive Surgical Procedure,Procedure, Keratorefractive Surgical,Procedure, Refractive Surgical,Procedures, Keratorefractive Surgical,Procedures, Refractive Surgical,Refractive Surgeries,Refractive Surgical Procedure,Surgeries, Refractive,Surgery, Refractive,Surgical Procedure, Keratorefractive,Surgical Procedure, Refractive,Surgical Procedures, Keratorefractive,Surgical Procedures, Refractive

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